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A Cheating Radiologist

via The Trial of a WhiteCoat – Part 14.

The radiologist that read the film had a habit of going to the surgeons the following day and asking them what they had found. He would open up a blank report so that it looked as if it was dictated at the time of the exam, but would then hold the reports as “preliminary” and finalize them after dictating in the results of the surgeries. That way it looked like he had picked up on all these small findings before anyone else knew about them. He was a decent radiologist, so no one seemed to mind that he was adding all these findings after the fact. Now it burned me.

I’m offended.

No.

That’s too light.

I’m pissed off as hell.

I believe the Americans call this kind of thing “Monday morning quarterbacking.”

Whatever you might call it, this is cheating in my book.

I don’t know why they let that radiologist get away with this kind of behaviour.

Moreover, I can’t believe that anyone would take the man’s reports seriously, leave alone the surgeons that he got information from. If by chance I was a surgeon in that hospital, I would intentionally throw him red herrings.

In case you haven’t been following Whitecoat’s account of his malpractice case, see previous posts of his epic saga here. Far better than reading any crime/legal thriller, cheap or otherwise. John Grisham could take lessons from Whitecoat.

*This blog post was originally published at scan man's notes*

Job Loss And Its Connection To Illness

Two very interesting articles were published recently on the health effects of job loss and on-the-job rejection.

The first article looks at the health of people who have been fired. They limited their study to previously healthy adults who got sick after they lost their jobs. It didn’t seem to matter why they were let go or how quickly they found a new job. Kate Stully, an assistant professor in sociology at the State University of New York at Albany and author of “Job Loss Can Make You Sick” found that losing a job is linked to a higher risk for high blood pressure, heart disease, heart attack, diabetes or depression. I would also add an increased risk of suicide to this list.

The second article looks at what happens when you’ve been left out (or just think you’ve been left out) of the loop at work. Purdue University’s professor of psychological sciences, Kipling D. Williams, reported that hurt feelings for a perceived slight can affect morale, hurt job performance and productivity, and can even hurt the company financially in his article, “Avoid the Dark About Effects of Leaving Others Out of the Loop”.

The first article looks at how we define ourselves and our place in society by our jobs. The second looks at how damaging a perceived slight can be to productivity. Now these two articles on the surface seem to be talking about two different things. But if we take a closer look, aren’t both of these articles talking about the effects of rejection?

No matter how much we would like to say we don’t care what other people think, we really do care much more so than we might think. And it hurts when we feel left out or feel unwanted. According to the first article, it can even make us physically sick. It matters that we feel needed and accepted by those who play a large part in our lives. And let’s face it; we spend a lot of time with our coworkers so it would naturally follow that these people would have some influence over how we feel about ourselves.

The second article explains how just a small amount of the cold shoulder can have a significant impact on how we feel about ourselves and how we perceive others feel about us.

So how do we cope with feelings of rejection in the workplace? Most of us spend more time with coworkers than we do our families, so they often become our second family. In some cases, our work family may be the only one we’ve got. And family rejection is often the most devastating to our self-worth.

The first step in dealing with any rejection is a critical look at the rejecter as well as the rejected. Is she really rejecting me by talking with another coworker? Sure, we were a team in the meeting, but after the meeting she talked to someone else in the hall. Does this mean rejection, or does this mean she had a follow-up comment to something that person said in the meeting? Is my being fired from my job a reflection on my job performance or downsizing of the company? If it is my performance, was the job really a good fit to begin with? How could I have changed the outcome to better serve me? Could I have stepped up my performance, or changed jobs to one that I liked better? How will I deal with this in the future? Do I really want to be a part of this group in the first place? Is my desire for alliance with this group solely based on popularity? Does this group fit with my own morals and ideals? We all want to fit in, but not at the expense of losing ourselves in the process.

The second step is to realize that in order to feel rejection we must first give someone else the power to do so. Am I setting myself up for rejection? According to psychiatrist, Karen Horney, we tend to move toward, away from, or against others. Am I open and meeting others half way? Am I waiting for others to come to me or making others work harder to approach me? Or am I mistakenly pushing others away from me by rubbing them the wrong way or coming on too strong when all I really want to do is connect? Am I trying to alienate others before they get the chance to alienate or reject me?

The third step is to understand that rejection is a negative experience just like any other and that the hurt lessens when shared with others. Sometimes we can “feel” rejection when we are not being rejected at all. If I was cheated on by a loved one, or a family member raked me over the coals for showing up late for dinner, I would find a sympathetic ear to talk it out with. By discussing rejection, we find that we are not alone. We may even find that our story is not so bad when others share their horror stories of rejection. And don’t worry about fearing that we’ve blown the situation out of proportion. Maybe we have not been rejected at all. Our true friends will be the first to tell us when we are full of hot air. Our fake friends will be the last to tell us when we are wearing our underwear on our heads!

I’ll leave you with a couple of quotes on fitting in:

“I refuse to join any club that would have me as a member” Groucho Marx

“I want my individuality, so why can’t I get a tattoo? Everyone else is.” My neighbor’s teenager

The floor is now open for your comments. Please join in.

*This blog post was originally published at eDocAmerica*

A Patient Encounter With Dr. Idiot

Earlier this week, I had a bit of a medical issue.  Painful urination, high blood sugars, and the constant need to pee.  (Ladies, I know you already know what’s up.)  Urinary tract infection looming large.  I was livid, because it was the day before I was scheduled to travel for this week’s business.

I haven’t got time for the pain, so I called my primary care physician, Dr. CT.  “Hi Nurse of Dr. CT!  It’s Kerri Sparling.  Listen, I’m pretty sure I either have a kidney stone or a urinary tract infection, and I need to rule it out before I leave for a week-long business trip.”

Dr. CT was on jury duty.  Damnit.  So I had to call a local walk-in clinic, instead.

The clinic was a hole in the wall.  Part of a strip mall structure.  My confidence wasn’t high, but my blood sugars were and my whole body was screaming for attention, so I knew I had to follow through.

The receptionist was very nice.  The nurse was even nicer.  They took my blood pressure (110/74), my temperature (98.8) and a urine sample (ew). THIS is not for urine, people!

I should have known from the moment the sample cup was given to me that it wasn’t going to be a fun visit.  The very kind nurse handed me this  —>

That is not a urine sample cup.  That’s like a party cup that you use for lemonade on a hot summer day.  Not for pee.  Oh God.

And then the doctor came in.  For the sake of anonymity, we’ll call him Dr. Idiot.

“Hi.  I’m Dr. Idiot.”

“Hi, I’m Kerri.”

“Kerri, I see you are here for pain when urinating.  Are you urinating frequently?  You see, you are spilling a significant amount of urine.  I believe we may have found the source of your troubles.”

He closed his file, proud of himself.

“Dr. Idiot?  On my chart there I wrote that I have type 1 diabetes.  I know my blood sugar is elevated right now, which sucks but at least it’s not a surprise.  But that’s not why I’m here.  I actually suspect that …”

He cut me off.

“I think we need to address this first problem.  You are aware of your diabetes, you say?  How many times a month do you check your sugar?  You know, with the glucose machine and the finger pricker?”

If I wore bifocals, it’s at this point that I would have slid them down my nose and given him a hard, Sam Eagle-type stare.

“I test about 12 – 15 times a day.  But the real reason …”

“You mean a month,”  he corrected me.

“No, I mean a day.  I have type 1 diabetes.  I wear a continuous glucose sensor.  And also an insulin pump.  I’m very aware of my condition, and I’m also very aware that it’s slipping out of control today because of this other issue, the pain issue.  Can we talk about that?”

He looked at my chart again.  “So you don’t use a meter?”

“Sir, I use a meter.  And a machine that reads the glucose levels of my interstitial fluid.  This is in addition to my insulin pump.  I don’t mean to be rude but …”

Now he gave me a hard look.  “Why the interstitial fluid?  Why not the blood directly?  I mean, you could have more precise readings with the blood.”  He picked up my Dexcom from the chair next to me and pressed a few buttons to light up the screen.  (Mind you, he did not have permission to touch it, but I’m again not saying anything.)

“You mean like a pick line?  I don’t know.  I’m sorry.  Ask them?”

“Yes, but it would make much more sense and …”

I just about lost it.

“I’m sorry.  I didn’t come here to talk about that.  I want to talk about the issue I’m here for.  Which is not diabetes.  Or your ambitions to know more about CGMs.  Please can we address what I’m here for?”

“The sugar in your urine.”  With finality, he says this.

“NO.  The fact that I think I have a UTI or a kidney stone.  Please.  Help.  Me?”

I kid you not – we went ’round and ’round about this for another ten minutes.  He didn’t believe me that I was at least sort of familiar with diabetes.  His ignorance included, but wasn’t limited to, the following statements:

  • “High sugar causes frequent urination.  Maybe that’s why you are peeing often?”  (Not because I was drinking a liter of water per hour to flush my system?  Nooo, couldn’t be that.)
  • “Did you have weight loss surgery?”
  • “Grape juice also causes high blood sugar.”
  • “That thing should really be pulling blood samples.  Pointless otherwise.”  (Meaning my Dexcom.)
  • “The urinalysis won’t be back until Friday, and in the meantime you should start on a regimen of insulin immediately.”
  • And also:  “I didn’t peg you for a pink girl.”  (Are.  You.  Serious??)

The end result, after an escalating argument that involved me yelling, “Stop.  Talking about my diabetes and PLEASE focus why I’m here!” was a prescription for Macrobid that I could elect to take if my symptoms didn’t alleviate, and the instructions to call back on Friday for official lab results.

“Thank you.  Really.  Can I go now?”

He at least had the decency to look ashamed.

I’ve had some wonderful doctors over the last 30 years, and my health is better for it.  But this guy?  Complete disappointment.

*This blog post was originally published at Six Until Me.*

Tilting At Windmills In Washington

Once again, I have to thank Dr. Val Jones for setting up the Putting Patients First event at the National Press Club in Washington DC on Friday. For a full summary of the pagentry, Dr. Rich does a much better job summarizing the whole event than I ever could, though I was uh, surprised about what he said of me (thanks, dude).

But one thing he forgot to mention was the moment when our moderator asked us what struck us most about what Congressman Paul Ryan had to say in his speech to us. I, being ever soft-spoken, piped up that I was struck that no one had read the bill and it was already on its way to the floor after being completely “marked up” early that very same morning.

So, while we might not have been chasing windmills at this event, I couldn’t help but wonder if it might come to this (with appologies to GA Harker, whose illustration I couldn’t help but Photoshop):

Click image to enlarge

-Wes

*This blog post was originally published at Dr. Wes*

Emergiblog In DC: The Panel, the Politics and the Ce-Ment Pond

RyanPodiumThis is Congressman Paul Ryan of Wisconsin, speaking at the Better Health “Putting Patients First” event  in D.C.

I should talk about how passionately he spoke about health care reform (he did), about why he does not believe government should be running health care (he doesn’t) or that he took the time to come and speak at 8 am even though he had been up until 2 am working on the health care bill (he did) or that he spoke right up until he – literally- had to run back to the House to vote (he did).

And I will talk about these things.

But first, let me state the obvious and get it out of the way so that I can go on to discuss the serious nature of the health care reform debate before us.

Whoa.

Seriously, is it just me or are politicians getting better looking?

There. Now I can move on to the meat of the matter.

(I had to say it because you all know I was thinking it!)

*****

This event marked my first time in Washington, and just being there is awe-inspiring. Seeing the White House from the car window took my breath away, literally. I felt like Ellie May Clampett marveling at the ce-ment pond.  The National Press Club is a museum in and of itself.  Mother Jones and I were hoping we’d catch a glimpse of Sanjay Gupta, but he must have been off doing neurosurgery or something.

*****

By now, you’ve probably read who was on the panel (Dr. Wes, DrRich, Dr.Rob, Dr.Kevin, me, and Better Health contributors Dr. Alan Dappen, Valerie Tinley, NP and “token” – his words, LOL – surgeon Dr. James Herndon).

I will tell you straight up that I learned much more than I contributed.

The panel shot from the hip and spoke from the heart. Some of us had notes, some of us illustrated our comments with anecdotes and one of us (*cough*) had no clue what was going to come out of her mouth until that moment.

I’ll give you a hint….it wasn’t Valerie…..

*****

For the record, those of us on the panel were not told what to say, how to say it or what to believe, nor were we chosen based on what we do believe.  Some discussed concepts that should be taken into account no matter what plan we end up with, others were definitely against a single payer plan run by the government (*raising hand*).

The inefficiencies of national health plans of other countries were illustrated/discussed.  This hit me later: we should look at what works in those plans, not just what is wrong with them.  We don’t have to emulate them, just learn from them, and that includes the good and the bad.  It also applies to any universal form of coverage, not just a government-run plan.

Wish I had said that at the time.

So much for thinking on my feet (or on my butt, as the case may be).

*****

There was some controversy about not having any patient bloggers on the panel.  There should have been. I hope that, as a nurse, I spoke for patients, but it was not the same as having someone there who navigates the system as a patient every single day.

patientbloggers

The patient bloggers were in the audience, though, and if you go to Twitter you can find the live tweeting at “#patientsfirst”. There was a pretty healthy debate going on in the Twitterverse while the panel was up on the dais.

Here I am with Lisa Emrich (Brass and Ivory) and Kerri Morrone Sparling (Six Until Me). Duncan Cross was also there, but my pic was blurry!

*****

While health care reform has been a hot topic for awhile, it was especially acute this week as the President was actively promoting a government run health care system and there seemed to be a huge sense of urgency to get what is called “America’s Affordable Health Choices Act of 2009″ passed ASAP.

The bill is over 1000 pages long.

I just downloaded it.

And Congress has not read it.

Folks, our representatives are being asked to pass legislation they have not had a chance to read.

While I will admit to being a bit unsure of exactly what happens in the Beltway (Civics classes and Schoolhouse Rock’s “I’m Just a Bill” notwithstanding), that can’t possibly be business as usual.

Can it?

*****

I’ll say one thing: no matter what we believe, why we believe it or what our role is in the health care system, it is a conversation rife with strong opinions and passionate debate.

And, in the end, because we are all patients in one form or another at some point in our lives, the conversation is about us.

So, when you hear the phrase “putting patients first”, think of it as “putting me first”.

That may help you get a foothold in the morass of information that is the health care debate.

It worked for me.

*This blog post was originally published at Emergiblog*

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